NEAHRING: Treatment of cough depends on cause

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I have a cough. It is not life-threatening, but it is terribly annoying. I would describe it as a tickle in my throat, although the word tickle makes it sound rather fun and festive, instead of an aggravating nuisance.

Rationally, I realize that it is just a little sinus drainage, but it is hard to be rational when I am sleep-deprived, feel like I am hacking up a lung and sound like I am spitting up a hairball. I am not alone in my misery, since cough is one of the most common complaints in the doctor’s office.

As annoying as it can sound and feel, a cough actually is an important body reflex and a key defense mechanism in the fight against excessive secretions and other airway irritants. Cough receptors in the respiratory tract send impulses to the cough center in the brain, which responds by sending a message to the muscles that control breathing, instructing them to forcefully expel air, dislodging mucus and clearing the airway of irritants.

Most coughs are caused by a viral infection such as the common cold. Drainage in the back of the throat, known as postnasal drip, is a frequent cause of a lingering cough. Other symptoms, such as a runny nose, sore throat, and/or congestion may be present, but cough often is the only symptom significant enough to be noticed.

Many children experience a post-viral cough, which lingers for up to a month after the acute upper-respiratory infection has gone away. Seasonal allergies also can cause a postnasal drip syndrome that can result in a persistent cough.

Asthma is a common cause of cough in children. Wheezing and shortness of breath are considered classic symptoms of asthma, but in many cases cough may be the only symptom.

Some childhood coughs, such as the barking cough of croup or the whooping cough heard in pertussis, sound very specific. Other coughs are caused by inflammation of the lower airway, such as bronchitis and pneumonia, and may be bacterial or viral in origin. Certain medications cause cough as a side effect.

There are dozens of other potential causes for cough, ranging from tuberculosis to GE reflux to inhalation of a foreign body.

Treatment of cough depends on its underlying cause. For uncomplicated viral infections or other coughs caused by posterior drainage, encourage your child to drink plenty of fluids to stay hydrated, thin out mucus secretions and keep his airway lubricated. Use a humidifier in the bedroom, since dry air tends to make cough worse.

Over-the-counter cough medications are a mixed bag. Parents expecting a magic potion that will make a cough disappear completely within a few doses will be disappointed, but for certain children I believe these medications can help relieve some irritating symptoms temporarily.

In general, the younger the child and the smaller the airways, the less likely medicine will be helpful and the more likely it may cause side effects. Multi-symptom medicines are available with antihistamines for drainage, expectorants to thin mucus, and cough suppressants, so talk to your doctor about appropriate options for your child’s age and symptoms.

Recent studies have shown that honey can be an effective cough medicine. Children older than 1 year old can take ½ to 1 teaspoon of honey to thin secretions and loosen cough. (Never give honey to children younger than the age of 1 because of the risk of botulism.)

Warm fluids such as water, lemonade or apple juice have been used successfully to loosen mucus and relax the airway, as well. In older children, cough drops or hard candy can soothe an irritated throat and calm a cough.

Call your doctor for any child with a cough who has difficulty breathing, seems to be getting sicker, has a fever longer than three days or has a persistent cough for longer than three weeks.

It turns out that one of the ingredients in chocolate, theobromine, has been shown to have cough suppressant properties. I’m not sure if M&M’s are really an approved therapy for my cough, but I’m willing to give them a try!

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